{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T07:00:57Z","timestamp":1771225257335,"version":"3.50.1"},"reference-count":26,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T00:00:00Z","timestamp":1754956800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T00:00:00Z","timestamp":1754956800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Among patients with severe mitral valve (MV) disease and predicted high\u2010risk of left ventricular outflow track obstruction (LVOTO), the patterns of treatment and clinical outcomes have not previously described. The aim of this study was to explore outcomes of this patient population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a single\u2010center study including all consecutive patients with severe MV disease who were evaluated by a multidisciplinary structural heart disease team for MV therapies between 2018 and 2023. All patients underwent pre\u2010procedural contrast cardiac computed tomography (CT). We defined high risk for LVOTO as a post\u2010transcatheter mitral valve replacement (TMVR) predicted neo\u2010LVOT\u2009&lt;\u2009150 mm\n                      <jats:sup>2<\/jats:sup>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 157 patients with a median Neo\u2010LVOT of 0 (IQR 0\u221280.4) were included. Median age was 79 (72\u221283), and most were females (89.2%). A total of 59 patients (37.6%) had severe mitral stenosis, 48 (30.6%) had severe mitral regurgitation, and 98 (58%) had both. The median STS score was 22.6 (17\u201329.6). Most patients were in NYHA class III or IV (77.1%), and the median KCCQ\u201012 was 48.9 (IQR: 29\u201368.7). Overall, the majority of patients were assigned to medical therapy (54.1%). There were a total of 41 deaths (26.1%) at a median follow\u2010up time of 247 days (IQR: 70\u2212568). When separated into non\u2010severe MAC and severe MAC, patients with severe MAC had higher rates of all\u2010cause mortality at 1 year (unadjusted HR: 2.44; 95% CI: 1.13\u22125.24;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02). Severe MAC patients were more likely to be assigned to medical therapy. Treatment allocation was not independently associated with a higher or lower risk of death.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Patients with severe MV disease at high\u2010risk for LVOTO (LVOT &lt;\u2009150\u2009mm\n                      <jats:sup>2<\/jats:sup>\n                      ) after TMVR were overwhelmingly female and were most frequently assigned to medical therapy. Patients with severe MAC had higher rates of death. Treatment allocation was not independently associated with mortality. Novel transcatheter therapies are needed to definitively treat this high\u2010risk population.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70091","type":"journal-article","created":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T13:45:16Z","timestamp":1755006316000},"page":"2488-2494","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Treatment Patterns of Patients With Mitral Valve Disease and Critical Neo\u2010LVOT Obstruction"],"prefix":"10.1002","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5206-1639","authenticated-orcid":false,"given":"Brian","family":"O'Neill","sequence":"first","affiliation":[{"name":"Center for Structural Heart Disease Henry Ford Health System Detroit Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adnan","family":"Halboni","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Henry Ford Health System Detroit Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gennaro","family":"Giustino","sequence":"additional","affiliation":[{"name":"Atlantic Medical Group Morristown New Jersey USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro","family":"Engel","sequence":"additional","affiliation":[{"name":"Center for Structural Heart Disease Henry Ford Health System Detroit Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgi","family":"Fram","sequence":"additional","affiliation":[{"name":"Center for Structural Heart Disease Henry Ford Health System Detroit Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiberio","family":"Frisoli","sequence":"additional","affiliation":[{"name":"Center for Structural Heart Disease Henry Ford Health System Detroit Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5611-8313","authenticated-orcid":false,"given":"Jonathan X.","family":"Fang","sequence":"additional","affiliation":[{"name":"National Heart Center Singapore Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"O'Neill","sequence":"additional","affiliation":[{"name":"Center for Structural Heart Disease Henry Ford Health System Detroit Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro","family":"Villablanca","sequence":"additional","affiliation":[{"name":"Center for Structural Heart Disease Henry Ford Health System Detroit Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5784-9924","authenticated-orcid":false,"given":"Dee Dee","family":"Wang","sequence":"additional","affiliation":[{"name":"Naples Comprehensive Health Naples Florida 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